The Most Reliable Birth Control We’re Not Using, Ctd

Rebecca Leber flags some new medical advice for teens: “The American Academy of Pediatrics has just revised its official position on birth control: The academy’s new guidance advises members to recommend intrauterine devices (IUDs) and progestin implants as the most effective birth control methods available”:

The announcement, which appears in the flagship journal Pediatrics, is important for its own sake— because it’s likely to change patterns of medical practice—and reduce the incidence of pregnancy. It’s also important for what it says about the ongoing controversy over who should pay for contraception. …

IUD usage in the U.S. is still fairly rare in the United States, especially among teens (just 3 percent of teens rely on IUDs). But that is finally changing, rising from just 2 percent to 8.5 percent between 2002-2009. One likely reason that may continue to change is, under the Affordable Care Act, all insurance policies must cover birth control fully, without extra out-of-pocket costs. Implanting an IUD is expensive—it can run several hundred dollars, without insurance—so the coverage makes a difference.

Some conservatives might bristle at the idea of pediatricians counseling teens about sex. But the new guidelines make clear that “Adolescents should be encouraged to delay sexual onset until they are ready.” The problem, the article explains, is that “existing data suggest that, over time, perfect adherence to abstinence is low (i.e., many adolescents planning on abstinence do not remain abstinent).”

It’s no secret that a lot of teens have sex; according to the report, nearly half of US high school students report having had sexual intercourse. Each year, 750,000 teenagers become pregnant, with over 80 percent of the pregnancies unplanned. But the recommended AAP guidelines are a huge step away from the current practices of the 3.2 million teenage women using contraceptives; in fact, it seems that the frequencies with which teens use contraceptives are inversely related to their efficacy.

Lurie notes that “male condoms are by far the most frequent choice of contraception, with over half of teenage women reporting condom use the last time they had sex. According to the Centers for Disease Control, condoms have an 18 percent failure rate.” IUDs, on the other hand, “can prevent pregnancy for up to 10 years with a failure rate of less than 1 percent.” Meanwhile, James Hamblin homes in on the economic impact:

The United States has more teenage pregnancies than any other wealthy country, and the cost of that is around $11 billion every year─in the form of public assistance, care for infants more likely to suffer health problems, and income lost as a result of lower educational attainment and reduced earnings among children born to teenage mothers. So it’s especially interesting that only about 4.5 percent of women 15 to 19-years-old currently use LARC [IUDs].